HomeMy WebLinkAboutBuilding Fire Damage Report 1988-3-13
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. FIRE D.AMIl.GE REPORT
OR
. ELECTRICAL HAZARD
TO:
FROM:
DATE: 3-L'1-W
Building Department
Springfield Fire Department
ID III \
t11. I
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. SUBJECT: Structural Damage to Building
Address or location of building
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Name of o~mer
Type of building
Estimated value of building $
Estimated loss to building' $
Date of fire J - ( ) -J~
Location of damage in building
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(Roof, Wall, Exterior, Interior, etc.)
Structural weakness as a result of the fire .-y(.J
(Burned rafters, Beams, Joists, etc.)
Additional pertinent information
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Electrical Hazard
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(Wiring, Outlets, etc.)
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Siqned
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:: I CO~:.mN?T, WR~ ~~IU.S :teE
," NO. . . .," NO.
- bistrictoCIncident" Spti.,...;~.e'pJr1
C' "1,0.( DAY ( YEAR "J =F
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- . I lNCIDENT ADDRESS 1 -."
, "} 3'1 I "~11A1~ <"-l
a OCCUPANTNAMECLa\, fm.MI) .. . ;.,..._____.
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.,~ 8US'NESS 0::: NAME:...... Fim. MIl ' '"!-" ADDRESS .' ...:....::.-
6 OWNER NAME (1M" rim,~? I ADDRESS
L.ei.l'lbi~~, H~/e^, .VI I,!.. i) /I.(NOJ.. s+.
o FIRE RUORTED BY (Lut, flnt., MI) I ADDRESS .
ffi~;\ " ~""":"_: T ' ,. \'; , l~q /. ttJ-.'N4/-f..:. -(.,
MP.'fHODof 0 TUpbouDinct 0 Radio iai ill (1'IeLiDe) INJl. MutualAid(uliDcuiahorin..ip~ODIy)
ALARM 0 Municipl.lAlarmSyswm 0 Vert.l "LJ VokeSicnalMuniAlarm .0 Roc:eiYed 0 GIveD 0 N/A
o Privtlt.A1umSyatem 0 NoAlarmR.c'd 0 NotClaaif"Il!dAbow
8 'OF FIRE SERVICE PERSONNEL , OF ENGINES RESPONDED I ,OF AERIAL APPARATUS RES/PONr.;W
RESPONDED 't ~
o Otber(Lilt) I TYPE O.F ACTION TAKEN
o _... 0 ........ HuanI
g Inve.tipUon 0 St.ancl. By
o Automatic ExL System 0 Ibnd.laid how/hydrant., ltandpip.
o Pi"t-connect boee/tank only 0 Masta' Stream Device
o Pre-<:onnect ho.e/hydrant. .tandpipe 0 Nut Cluaif"led Abcm
I PROPERTI' COMPLEX ::':Iicab.ltl I MOBILE P~RTY (Complm line M)
I MODEL ~ I SERIAL I ..---...
I EQUIPMENT INVOLVED IN JGNITiON (Complete Line E)
LJA-/{ He....+__
I MODEL I SERIAL'
p'~O? H r-
. _, ~S!ATE OF OREGON FmE REPOR~ .. \.'
,', :' 8TATEFmEMARSHAL FIRE DEPT.
ALARM NO.
County !-A.", .. - " ~ IJept.llaponding
o 1'1.. 0 Tbut 0 s.tur ALARM TIME ARRIVAL TIME I
o Wo<!. 0 FriO<J J. "] t~lf ,} II b::!- .?~,
91~P771 :;JSUSTRAcr l 'jt.ASS
I 008 (oplioD&l) Tln.EPHONE
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I '1>81""""0011 TELEPHONE
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I ITEM FIRST ICrlTED:
r ....!.t:,.Jk'-
o 8elowlfCilevel
o NOl Cluaif"ted
.001 ,-..0tJw
.00 I
,l!Ps.n
o Moo
,
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9 TYPEOFSrnJATlONFOUND
.EI. .........."'"
o Oth.r Prop, _fvalult
10 METHOD OF
EXTINGUlSHMENT
o V.hideFire
o Bruah, GRM, Leave.
o Truh, Rubbish
o
~
Selt-EJ;tinauilhed
Mab-shitt .id.
PortabJe::.
II FIXEDPROPERTYUSE
I ;= M. .1'') J.1 (b11!'''Ifi
M ~~~~ ., y~ I MAK.E _
(/4 12 ROOM/AREAOFFIREORlGlN
-- Iuf'U/~_U
E F.QUlPMENT J I YEAR I MAKE
INVOLVED (, J v1
IN IGNITION ~S? fVlJ -rrlll..
13 IGNITION FACTOR
Q.1!\t~ rAil!'/... 70 C./.~e T;, tI.-...~_ 1-4*fUL
" '};{;;;;:;;~7~~ 'MA~~fT"GNITEDWASMADEOF
15 LEVELOFFlREORlGJIl - B IOtol9f_ U 3Oto"9feet 0 Over 70 feet.
)CO Gr8deleYelto9C. 2U to 29 feet. 0 6Oto70feel 0 ObjecUinFtight
IS VALUE BUildinl.oo Contents.oo VehklelUldContmta
. ~,.r;. dCl 0 M. tT7Jr) -..
. (l,tJtJO
11 NUMBEROF&70RIEl:I 8 2stone. 8 5toSstories
.8' Iltery 3to4 storie. 7 to 121terie.
18 BUILDINGA~lnYeus) I 8U1LDING SIZE fGmd Ftr Only) !:f t000.4999sqft
- y..'t , ,~. 0 O-999sqft .. 0 5000-9999lQft
19 CONSTRUCTJOllVtYPE U Hen)' Tbn.ber U Unprotect. Steel BIdJ
o Su.I"Cooc:r.te.3-.f.hr.{lrm. 0 Pn::rtert.Su.lBIdc 0 Prolect.Muonry&'t."Woodlnt.
EXTENT OF DAMAGE CONnNED TO: Flam. Smoke DETECTOR PERFORMANCE
I 'Th.ob)ertolori(in :'! I 0 0 I IDroomoCori(in-oper.
2 Panofroc:tmoruuofon,m 2 0 D' 2 Nolin roomoCoric:in-oper.
20 3 RoomoloripD 3 0 0 3 IDrmoforiDn-DOtoper-firetoo~
4 Ftnt.rat.-lc:om.p.ofori(in 4 0 ,,0 0" Notinrmofo~-:'~!2per.rU"ltoomWJ
5 FIooroCoririn Ii 0 Ii.q 0 5 IDroomofor4in-notoper.powerdilconnoct
IS Slluctureoforicin 8 0 IS ~ JI. 6 Not in rm of origin-not oper. power diIcon.
7 Enend.dbeyonchtructuruforirin 7 0 7 0 0 7 IZI.rootDoCor'igin-notoper.de:adbe.ttery
o 8 Notinroomoforicin-noloper.deadbett.ery
9 G 0 9 Nodetect.orpre:sent 0 10 Undl!termined
LOss
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.00
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, I' OTHER VEHICLES RESPONDED
(do DOtindudePA'sl .I
Os......
o Not Clusified
o Undetermined
IUC~
I VOLTAGE
~...tO
~
D Undmrmined
TOTAL
.00 4."', 000 .00
.00 3_000 .00
813to2"St.oria
25 to 49 Itoria
o IO.OOO.19.999eqft 0 5O,OOO.99,999sqft D flOO.ooosqft
o 2U,OOO-49.9991Q ft 0 100,000.499,999 eq ft \,
.2 Unprot<<t. Maonry E..t." Wood Int. 0 Unprolected Wood Flame
,. 0 Protected Wood Frame 0 Not ClusilWd AI:loft
SPRINKLER PERFORMANCE
1 0 Equipmenloperatad
2 0 Equip.IhouJdb.V.oper.-didDOl
3 0 Equip.pl'ftenlrU"ltoomWItooper.
9 0 Notc....if"~.bow
o 0 Undetermined. or not reporud
8 0 No equipment praenl (N/Al
9 NodamquCthe type (N/AI
21 REMARKS W~tber Conditiona (optionall:
I, .2 Fo.... Up '........Iio. -.... Y t<- N_
o
0. ~lw.:.L
lfyee, who will investipte
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23 Numbern{lnjuries
fireServiClll
00..,
I
l Numbero{f.talities
. FireServi~
Title
24 Member Makin<< Repon
~F
25 AdditionallnlormelXln by
,
Title
814-44().10 (A-86)
o 5OstorieaOflDON
Sprinklei'll Controlled Fire;
, of Heads Opened
YESO NOD
fil cont. on becll
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Othtr 71
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